Endometriosis (chocolate cyst)

Endometriosis, (chocolate cyst) endometrium normally found only in the uterus
benign, sensitive to the hormone estrogen, where the tissue is located in a tissue outside the uterus,
is an inflammatory disease. Endometrium tissue is the tissue that normally lines the lining of the uterus.
tissue, which proliferates every menstrual cycle to prepare for pregnancy, pregnancy
in the absence of a menstrual cycle, it is broken down and shed during menstruation, and is excreted through the vagina with menstrual blood.
is excreted. In endometriosis (chocolate cyst), this tissue is formed in an abnormal way.
Points outside the uterus are called foci of endometriosis. Endometriosis
foci may be small or very diffuse. Most often located in the pelvic region, but
It can also occur in different areas, such as the intestines and diaphragm. Endometriosis (chocolate
cyst) inflammation, dysmenorrhea (painful menstruation), dyspareunia (pain during sexual intercourse),
chronic pain and infertility. These symptoms are very mild in some patients, while in others
may cause severe complaints in patients.

The exact cause of endometriosis is not yet known. The most likely theory is retrograde
is mesnstruation. This means that with menstruation, which happens every month, some of the blood flow
endometriosis as a result of flowing backwards through the tubes into the abdomen instead of flowing out
(chocolate cyst) foci are thought to be formed. However, in most women, menstruation
while some of the blood flows into the abdomen, most do not develop endometriosis (chocolate cyst), this
also suggest that there may be additional factors. Some of the alternative theories include
cells or embryonic remains from the developmental period in the womb
endometriosis (chocolate cyst) may be developing or the blood circulation or lymphatic system
endometriosis is the formation of endometriosis by the spread of endometrial cells throughout the body. All these
theories include the body’s inability to clear endometrial cells outside the uterus, immune
system may also play a role in the development of endometriosis.
In studies, endometriosis has also been associated with some genetic abnormalities.

The prevalence of endometriosis is difficult to determine precisely because some patients
is asymptomatic and definitive diagnosis is made surgically. In the reproductive age group
It is estimated that approximately 10 percent of women suffer from endometriosis.
The incidence increases to around 50 percent in infertility patients.
Endometriosis is most common in the 25-35 age range, but it can also occur before menstruation or
It can also be seen after menopause.
Factors that increase the risk of endometriosis (chocolate cyst) – nulliparity (not giving birth
early menstruation (before the age of 11) or late menopause, short menstrual cycles (≤27
days), heavy menstrual bleeding, conditions that prevent the flow of menstrual bleeding (such as cervical
stenosis, müllerian anomalies )
Factors that reduce the risk of endometriosis (chocolate cyst) – multiparity (multiple
giving birth), long breastfeeding intervals and late menstruation (after the age of 14)

Common symptoms in patients with endometriosis (chocolate cyst) are as follows:
– Chronic abdominal/pelvic pain
– Infertility
– Dysmenorrhea (painful menstruation)
– Dyspareunia (pain during sexual intercourse)
– Heavy menstrual bleeding
More rare symptoms include bowel and bladder dysfunction (pain, urgency
sensation, increased frequency) low back pain, irregular menstruation, low back pain, chest pain , chronic
Some endometriosis (chocolate cyst) patients may be asymptomatic. These patients
It is usually diagnosed incidentally while undergoing surgery for another reason.

How endometriosis impairs fertility is unclear and depends on the stage of the disease.
theories exist.
Mild endometriosis (chocolate cyst) triggers inflammation, the secretion of
secretions called cytokines and chemokines and immune cells in the ovary, tube and endometrium
impairs its function. This impairs the maturation of the eggs, fertilization and
affects its implantation into the tissue.
Advanced endometriosis additionally causes anatomical distortion and adhesions
in the uterus. This can affect the release and collection of the egg, the movement of the sperm, in the uterus
may cause irregular contractions, impair fertilization and embryo transport.

Treatment is planned according to the severity of the patient’s endometriosis-related pain. The patient’s pain
If possible, it is managed with medical (medication) treatment and in cases where it is not sufficient, surgery
is considered.
Mild or moderate pain (i.e. pain that does not interfere with work)
for patients with endometriosis (chocolate cyst), nonsteroidal anti-inflammatory drugs (NSAIDs) and
birth control drugs hormone therapy (estrogen progestin combinations, progestin
preparations, subcutaneous implant, medicated intrauterine device (i.e. spiral). Hormone
treatment aims to suppress endometriosis that is sensitive to the hormone estrogen. This is
treatments have few side effects and are sufficient for most patients. After three to four months of this dual treatment
then the patient is re-evaluated. Women who have benefited from the treatment can continue until they want to get pregnant or
may continue this treatment until menopause. Some physicians use a gonadotropin-releasing
with hormone (GnRH) analogs (naferlin, leuprolide, buserelin, goserelin, triptorelin)
endometriosis (chocolate cyst) treatment.
In cases of severe pain (e.g. pain that interferes with work), the above treatments
endometriosis (chocolate cyst) whose pain cannot be adequately treated or recurrent
patients, additional therapies for diagnosis and treatment (GnRH analogs, aromatase inhibitors)
can be started.
Endometriosis (chocolate cyst) whose pain does not respond to treatment with the mentioned medications
our next option for diagnosis and treatment is endometriosis surgery. This
surgery can be performed with open or closed technique, but it has many advantages compared to open surgery
laparoscopy (closed surgery) is primarily preferred. Endometriosis (chocolate
cyst) surgery, the foci of endometriosis are removed and adhesions are opened.
Surgical treatment is conservative if the endometriosis patient has a desire for pregnancy and is young.
(preserving uterine and ovarian tissue). Endometriosis not planning pregnancy
(chocolate cyst) patients, taking into account their age, the uterus and ovaries
surgical treatment can also be planned.

In the treatment of women with endometriosis who have infertility and want to become pregnant
we can’t use birth control pills. In the treatment of endometriosis-related infertility, the priority
Our option is in vitro fertilization. In women with pain due to endometriosis, non –
We provide pain control with steroid anti-inflammatory drugs. Endometriosis (chocolate cyst)
surgeries used to be recommended for women who wanted to become pregnant, but nowadays
surgical removal of endometriosis (chocolate cyst) may decrease ovarian reserve
and is not preferred in the first step because it is thought to reduce the chances of pregnancy.

Deep endometriosis, the disease affects the uterosacral ligaments (the ligaments that hold the uterus), the lower abdomen
into the depths of the cavity inside, spreading to the intestines, ureters or bladder
is the name given. In symptomatic patients with deep endometriosis, hormonal therapy and non
Treatment with steroidal anti-inflammatory painkillers is appropriate. However, ureteral, intestinal obstruction
or surgical treatment is applied in women whose complaints do not improve with medication.

Rarely around the upper abdomen, diaphragm, abdominal wall, chest, anus and vagina
endometriosis can be seen. In these cases, it is important to prevent the progression of endometriosis and
with gonadotropin-releasing hormone (GnRH) analogues (hormonal therapy) to control
ovaries are suppressed, estrogen production decreases and estrogen-sensitive endometriosis
tissue growth can be limited.
Treatment of endometriosis causing ureteral or intestinal obstruction
is surgery.

The best treatment method for women who do not respond to drug treatment in endometriosis
laparoscopic endometriosis surgery. Laparoscopic surgery involves a large incision in the abdomen
endometriosis foci with the help of a camera by entering with devices through small holes without opening
nerve transection procedures can also be performed, in which the pain-transmitting nerve fibers are damaged to treat the pain.

Laparoscopic endometriosis surgery has many advantages over open surgery
are available. The main advantages of laparoscopic surgery are smaller surgical scar, less
risk of bleeding and infection, faster recovery, intra-abdominal pain that can be seen after surgery
adhesions are less common in laparoscopic surgery, less postoperative pain and
Laparoscopic endometriosis treatment with laparoscopic surgery enables the diagnosis and treatment of endometriosis precisely by removing and examining the focus. At the same time, it can enable endometriosis patients with infertility (infertility) to become pregnant with uterus-ovarian protective conservative method. Laparoscopic endometriosis surgery and IVF treatment, vaccination
Assisted reproductive techniques, such as assisted reproductive techniques, can increase the chances of pregnancy in patients with endometriosis.

Nerve transection : Laparoscopic uterosacral nerve ablation (LUNA) and presacral
neurectomy (PSN), the nerve that transmits pelvic pain in endometriosis
can treat pain by controllably damaging the fibers.

Treatment of endometriosis with laparoscopic surgery, advanced laparoscopic surgery
It is an operation that requires experience and skill. All problems related to endometriosis
solution, both in treatment with laparoscopic surgery and when you want to have a child.
With IVF treatment, we are at your side throughout the treatment process with our experienced doctor staff.

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